Transfusion Reactions

Authors: Fatema Hassanali / Editors: Frances Balmer / Codes: / Published: 02/09/2024

Blood and other blood components are frequently administered in the Emergency Department (ED). Transfusion reactions range from mild to life threatening, and it is therefore important for clinicians to be able to assess, investigate and manage these presentations.

Learning objectives

After completing this session, you will be able to:

• Define the different types of acute and delayed transfusion reactions
• Recognise the pathophysiology, signs and symptoms of the different types of transfusion reactions and specifics of management for each
• Develop a general approach to the investigation and management of acute transfusion reactions
• Understand the principles of haemovigilance and reporting requirements.

References

1. Stanworth S, Evans H, Sherliker L. The future of data in transfusion medicine [internet]. 2023 [cited 2024 Apr 4].
2. Narayan S, Poles D, et al. on behalf of the Serious Hazards of Transfusion (SHOT) Steering Group. The 2022 Annual SHOT Report, 2023.
3. Soutar R, McSporran W, et al. Guideline on the investigation and management of acute transfusion reactions. Br J Haematol. 2023 Jun;201(5):832-844.
4. Norfolk D. Handbook of Transfusion Medicine. 5^th ed. Norwich: TSO; 2013.
5. Robinson S, Harris A, Atkinson S, Atterbury C, Bolton-Maggs P, et al. The administration of blood components: a British Society for Haematology Guideline. Transfus Med. 2018 Feb;28(1):3-21.
6. Weinberg JA. BMJ best practice: Transfusion reaction [Internet]. 2023 [cited 2023 Oct 4].
7. Panch SR, Montemayor-Garcia C, Klein HG. Hemolytic Transfusion Reactions. N Engl J Med. 2019 Jul 11;381(2):150-162.
8. Laureano M, Khandelwal A, Yan M. Transfusion reactions. In: Khandelwal A, Abe T, editors.Clinical Guide to Transfusion[Internet]. Ottawa: Canadian Blood Services, 2022 [cited 2023 Oct 6]. Chapter 10.
9. American Red Cross. A Compendium of Transfusion Practice Guidelines. 4^th ed. [Internet]. 2021 [cited 2023 Oct 6].
10. Sandham J, Altemimi B. Safety considerations and risks of Transfusion. Anaesth. Intensive Care Med 2021; 22(8): 4827. doi:10.1016/j.mpaic.2021.06.005
11. Serious Hazards of Transfusion (SHOT). UK haemovigilance: MHRA/SHOT haemovigilance reporting user guide. [Internet]. 2021 [cited 2023 Oct 10].